Stress, agony of operating Uganda’s dead mortuaries

Wednesday December 19 2018

The state of the post mortem room in Jinja Regional Referral Hospital mortuary.

In Summary

Challenges. When death occurs, corpses need to be kept for several days because of delays occasioned by formalities from different authorities such as police. However, a survey by Monitor team reveals that hospitals across the country are struggling to manage them.

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By MONITOR TEAM

The state of most mortuaries in the country is shocking, Daily Monitor has established. Limited space, lack of refrigeration services as well as poor standard tables for postmortem and laboratories for testing specimens pose great challenges to the efficient running of the morgues. Other challenges include inadequate personnel to man the buildings and rooms where dead bodies are kept before burial or cremation.

In the countryside, there are no streetlights on the roads or pathways leading to the dilapidated morgues and at night, mortuary assistants or undertakers wheeling the bodies to and from the buildings are guided by only torchlight. Sometimes, when a major accidents occurs and there are several casualties, bodies are piled one on top of the other.

And often, corpses need to be kept for several days because of delays occasioned by formalities from the police.In such cases, the bodies are left to waste away, leaving postmortem examinations to be conducted with huge stress. For preservation of the bodies, the essential air-conditioning and an ice cube chamber are lacking.

Lira Hospital mortuary, which receives on average seven bodies on a daily basis, does not have a refrigerator.

While the mortuary at Sembabule Health Center IV, which acts as the district hospital, is more or less disused and has no door. In 2016, some unknown people took advantage of a power blackout in Sembabule District, kidnapped a patient from the ward and hid him in the mortuary. But Ms Joelia Mukabalisa, the Sembabule District secretary for Health and Education, now says they have mobilised funds to renovate the mortuary.

Similarly, the Bududa Hospital mortuary, like most mortuaries in the country, has no refrigeration services and one is greeted by a knockout stench whenever one dares the no-go area to pick up the remains of a loved one.Dr Sylivia Ntegeka, the Bududa Hospital superintendent, says the mortuary at Bududa Hospital does not have a refrigerator for preserving dead bodies.“The mortuary is too small to accommodate more than five bodies but when the facility is overwhelmed, some of the bodies are transferred to Mbale Hospital mortuary for further management,” she says.“Despite the fact that a small percentage of the hospital budget is allotted to run the mortuary, it is rather meagre to effectively address some of these challenges,” she adds.

In Hoima Municipality, the mortuary looks abandoned while its satellite facilities upcountry has bodies rotting away. The hospital authorities say in most cases, relatives of deceased end up traumatised and in tears and shock upon seeing the bodies of their beloved ones in such sorry condition.

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In October 2018, about 15 unclaimed bodies were piled up at Moroto Hospital mortuary before the remains were collected by Moroto Municipal Council authorities for burial in a public cemetery. Dr Alfred Ogwang, the Moroto Hospital director, says the facility does not have any piece of land to be used for the burial of unclaimed bodies.“The irritating smell out of the mortuary is disturbing and affecting some of the nearby restaurants in the town,” he says.

At Atutur Hospital in Kumi District, the situation is not any different. The mortuary at this government hospital on the Soroti-Mbale highway is operating without a refrigerator.Ms Stella Alupo, the hospital administrator, says the mortuary which serves Bukedea, Kumi, and Ngora districts and parts of Serere, also suffers space constraint. “When bodies that are dropped in take long to be claimed by the relatives, it leaves the hospital with a bad stench,” she explains.

The mortuary at Mbale Hospital has a capacity to handle less than two bodies. However, it has four trained technicians manning this facility, Dr Emmanuel Tugaineyo Ituuza, the hospital director, says.

Also, the mortuary at Soroti Hospital lacks the much needed components to meet the desired standards for proper preservation of dead bodies.The Soroti Hospital director, Dr Francis Mulwanyi, confirms: “It’s a challenge, our mortuary services are affected by limited space and the refrigeration system that has a maximum capacity to preserve [only] two dead bodies.”

Meanwhile, Masaka Hospital does not have its own mortuary and has since been relying on Masaka Municipality mortuary, which is adjacent to the hospital. But Mr Edward Kabuye, the hospital principal administrator, says: “We are happy to report that this financial year, we shall acquire a modern mortuary fridge, which will help us to keep bodies in good shape,” he says.

Fort Portal hospital has a modern mortuary that can accommodate about 50 bodies but the mortuary is ill-equipped. The mortuary has one cooler, which accommodates only three bodies and sometimes it does not work.The hospital serves the Rwenzori region which includes Kabarole, Kamwenge, Kyenjojo, Kasese, Bundibugyo, Ntoroko, Bunyangabu, Kyegegwa districts.

The officer in charge of the mortuary, Mr David Ndikumwami, says they have no chemicals to treat bodies and that the one cooler is inadequate for the hospital that serves at least eight districts.Mr Ndikumwami says in case of overflow, they use Fort Portal Municipal mortuary which accommodates about 20 bodies.“Since the mortuary is not well equipped, people who lose their loved ones and their bodies are taken to the mortuary are made to pay some money in order for the bodies to be treated,” Mr Ndikumwami says.

In northern Uganda, Gulu Hospital mortuary accommodates eight bodies but the unclaimed bodies are normally kept at the facility for over month.“At times police also dump bodies at the facility and there are no follow-ups on the matter,” the senior hospital administrator, Mr Paul Ajuk, says.

Atiak Health Centre IV in Amuru District does not have a mortuary. The district health officer, Dr Patrick Odong Olwedo, says: “We use a small building which is supposed to be a theatre. In most cases, whoever loses a beloved one, the body is picked up immediately since we have no better provision to keep the bodies at the facility.”He, however, says plans are underway to have a mortuary.

In the entire Agago District, there is no mortuary. “At times bodies are taken to Dr Ambrosoli Memorial Hospital in Kalongo whenever the need arises,” Dr Emmanuel Otoo, the district health officer, says.

In Moyo District, the refrigerator at Moyo Hospital has broken down, rendering its mortuary non-functional.Mr Bernard Besi, the senior hospital administrator, confirmed the mortuary had not been operational for two weeks by the time of filing this report. “It is true, our refrigerator is faulty and we have already informed the regional mechanical workshop that is responsible for repair and maintenance of medical equipment. They told us they would come to put it right,” Mr Besi said on November 10.

At Arua hospital, the mortuary is functional with minimal challenges, according to the hospital administration. Bodies there are treated and kept, especially for those whose relatives have a not shown up to claim the bodies.

Mr Rajab Kito, the Jinja municipality public relation officer, says Jinja Municipal Council does not also have mortuary. Jinja Regional Referral Hospital administrator, Mr Mubaraka Were, says bodies of accident victims, bodies recovered from water and dumped in bushes or sugarcane plantations are some of the challenges facing the hospital.

Nakaseke Hospital mortuary was only recently rehabilitated by the government under a Shs5 billion Health Sector Support Project. The money for the renovation of the hospital was a loan secured from World Bank. The mortuary has a fridge with the capacity of storing nine bodies at one go, the hospital senior administrator, Mr Ntumwa Matovu, says.But the frequent power outages due to a faulty transformer is a huge challenge currently facing the facility.“When we do not have electricity to power the fridge system, the hospital faces a challenge of storing the bodies,” Mr Ntumwa says.

OTHER AREASKabale. In Kabale District, the issue of personnel has remained a stressing challenge. For instance, Kabale Hospital has a complete mortuary manned by two qualified mortuary attendants, Dr Sophie Namasopo, the hospital director, says.“Our mortuary has one fridge that can preserve three bodies at ago. However, one of the challenges here is the delay to pick up unidentified bodies,” Dr Namasopo says.She adds the unidentified and unclaimed bodies are always handed over to Kabale Municipal Council authorities for burial in the cemetery.

Kisoro. The Kisoro Hospital medical superintendent, Dr Michael Baganizi, says their mortuary lacks a refrigerator for storing dead bodies.“In cases of unidentified and unclaimed bodies, the hospital administration hands them over to the municipal council authorities for burial in the cemetery,” Dr Baganizi says.Nakasongola. The mortuary at Nakasongola Health Centre IV is in good state and has a functioning fridge. The fridge has a capacity of storing six bodies at once, Mr Agaba Byamukama, the 0district health officer, says.